| |
40 N Union Rd, Niswander Eye Center, Williamsville, NY 14221-5339 | |
(716) 634-4441 | |
(716) 634-3174 |
Full Name | |
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Type | Facility |
Speciality | Ophthalmology |
Location | 40 N Union Rd, Williamsville, New York |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144284043 | NPI | - | NPPES |
01632920 | Medicaid | NY | |
390088001 | Other | NY | BLUE CROSS GROUP NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | VUT005781-1 (New York) | Secondary |
207W00000X | Ophthalmology | 142714 (New York) | Primary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Secondary |
Provider Name | Philip R Niswander |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1306844550 PECOS PAC ID: 8921070046 Enrollment ID: I20100831000438 |
Provider Name | Mary Ellen Loughrey |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1801894068 PECOS PAC ID: 0244415198 Enrollment ID: I20110419000982 |
Provider Name | Ellen C Fitzgerald-farkas |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1215192638 PECOS PAC ID: 8820267669 Enrollment ID: I20110811000434 |
Mailing Address | Practice Location Address |
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40 N Union Rd, Williamsville, NY 14221-5339 Ph: () - | 40 N Union Rd, Niswander Eye Center, Williamsville, NY 14221-5339 Ph: (716) 634-4441 |